Joint Surface Damage

How it happens

Usually happens gradually over time and can be due to uneven distribution of weight passing through the joint (similar to the effects of faulty wheel tracking)
Localised areas of damage could be caused by a twisting injury or fall.

Symptoms

Dull aching deep in the knee, often night pain
Chronic ache which gets worse after activity
Sharp pain when twisting or turning

Treatment

Consultation with an orthopaedic surgeon , an MRI scan may be needed Physiotherapy and an off loading brace could help relieve immediate pain
Arthroscopic operation (key hole) Day case or 1 night stay Should be able to drive between 4 days and 2 weeks Return to light work – 1 week
Return to full activities in 6 – 8 weeks, impact or contact sports may take longer

Outlook

Treatment can reduce the progression, relieve pain and allow a return to normal activity and sports. If untreated, damage may progress leading to arthritis and eventual knee replacement

Operations

Chondroplasty

Procedures carried out on areas with minor damaged are aimed at removing debris and smoothing surfaces to remove irregularities
Your return to normal activity will be governed by discomfort and swelling. These are not usually severe and, if you were quite fit before surgery, you could be back to normal in a few weeks.

Abrasion Arthroplasty/ Micro fracture

In more severe cases, advanced modern techniques aim to produce an element of healing. At operation the damaged cartilage surrounding the lesion will be cleared thus leaving a ‘crater’. The bottom of the crater is either abraided or drilled to produce bleeding of the underlying bone – this bleeding will form the basis for the development of new fibrocartilage and should produce a more even joint surface.

Your return to light activity will take about 2 weeks but the full healing process does take a long time and it could be 9-12 weeks before all activities become completely comfortable. The physiotherapist will guide you and recommend exercises and activities which will promote rather than inhibit healing.